Provider Demographics
NPI:1568266435
Name:FLAKE, JANIA (ATC)
Entity type:Individual
Prefix:
First Name:JANIA
Middle Name:
Last Name:FLAKE
Suffix:
Gender:
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10101 HANOVER CT
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72908-0760
Mailing Address - Country:US
Mailing Address - Phone:479-561-8845
Mailing Address - Fax:
Practice Address - Street 1:10101 HANOVER CT
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72908-0760
Practice Address - Country:US
Practice Address - Phone:479-561-8845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer